Devolution and the Scottish NHS

摘要

Scotland, with a population of five million people, is in that respect comparable to an English health region. Thereafter, similarities fade. Responsibilities for the NHS in Scotland lie, not with a regional authority, but directly with a Scottish Office minister and his civil servants in St Andrew's House, Edinburgh. Per capita spending on health is higher in Scotland than in England, yet many health indicators remain obstinately worse. And even the history of the NHS in Scotland is different; a separate piece of legislation—the National Health Service (Scodand) Act 1947—established different procedures for appointing consultants and greater participation by universities in the running of the service, and sought to ensure that "the special virtues of the Highlands and Islands Medical Service would be protected and extended to the nation as a whole."